Immunosuppressant dose adjustment in chronic renal impairment
| Drug | Accumulates in chronic renal impairment | Potential for nephrotoxicity | Chronic renal impairment (GFR, mL/min/1.73 m2) | ||
| Stage III (30–59) | Stage IV (15–29) | Stage V (<15) | |||
| Adjustment (% of standard dose) | |||||
| AZA | No | No | Normal | 75%–100% | 50%–100% |
| MTX | Yes | Yes | 50% | Contraindicated | Contraindicated |
| MMF | Yes | No | Normal | 1 mg two times per day max | 1 mg two times per day max |
| CYC | Yes | Yes | According to age and serum creatinine (table 13) | ||
AZA, azathioprine; CYC, cyclophosphamide; GFR, glomerular filtration rate; MMF, mycophenolate mofetil; MTX, methotrexate.